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General NPI Number Information
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NPI Number | 1457948226
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Entity Type | Individual
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Provider Name | VENUSSA ARAYA PANG
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Gender | Female
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Dates
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Enumeration Date | 12/28/2020
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 918 E 60TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90001-1019
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Country | US
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Telephone | 323-233-0425
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Fax |
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Provider Business Mailing Address
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Address Line | 4211 AVALON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90011-5622
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Country | US
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Telephone | 323-233-0425
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW127161
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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